National Hospital for Neurology and Neurosurgery, London, UK.
Anaesthesia. 2011 Nov;66(11):1012-6. doi: 10.1111/j.1365-2044.2011.06853.x. Epub 2011 Aug 18.
Tracheal tube cuffs are commonly inflated to pressures exceeding the recommended upper limit of 30 cmH(2)O. We evaluated whether a stethoscope-guided method of cuff inflation results in pressures within the recommended range. Patients were randomly assigned to receive one of two methods of cuff inflation. In the standard 'just seal' group, air was introduced into the tracheal cuff until the audible leak at the mouth disappeared. In the stethoscope-guided group, air was introduced into the cuff until a change from harsh to soft breath sounds occurred, whilst listening with a stethoscope bell placed over the thyroid cartilage. Twenty-five patients were recruited to each group. The median (IQR [range]) cuff pressure in the 'just seal' group was 34 (28-40 [18-49]) cmH(2)O, and in the stethoscope-guided group was 20 (20-26 [16-28]) cmH(2)O, p < 0.0001. The stethoscope-guided method of tracheal tube cuff inflation is a novel, simple technique that reliably results in acceptable tracheal cuff pressures.
气管导管套囊通常充气至超过推荐的上限 30cmH2O。我们评估了听诊器引导套囊充气法是否可使压力处于推荐范围内。患者随机分为两组接受套囊充气的两种方法之一。在标准的“刚好密封”组中，向气管套囊内注入空气，直到口腔处的可闻漏消失。在听诊器引导组中，向套囊内注入空气，直至听诊器钟形听诊器置于甲状软骨上时听到的呼吸音由粗糙变为柔和，从而发生变化。每组纳入 25 例患者。在“刚好密封”组中，套囊压力中位数（IQR [范围]）为 34（28-40 [18-49]）cmH2O，在听诊器引导组中为 20（20-26 [16-28]）cmH2O，p<0.0001。听诊器引导的气管导管套囊充气方法是一种新颖、简单的技术，可可靠地产生可接受的气管套囊压力。
